NPIMap

Organization Active NPI

Lindengrove Communities LLC

Doing business as LindenGrove Waukesha

  • Skilled Nursing Facility
  • Waukesha, WI
National Provider Identifier
1780766451
Registry record updated Jul 10, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
2972 Issued in WI
Legal business name
LINDENGROVE COMMUNITIES LLC
Doing business as
LindenGrove Waukesha
Practice address
425 N University Dr
Waukesha, WI 53188-3174
Phone
(262) 524-6400
Fax
(262) 524-9233
NPI assigned
Oct 20, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Julie Anne Marks
Title
Cfo
Phone
(920) 261-0400

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 2972 WI Primary

Addresses

Primary practice location

425 N University Dr
Waukesha, WI 53188-3174

Mailing address

1045 Hill St
Watertown, WI 53098-3015
Phone (920) 261-0400

Other identifiers 2

IdentifierTypeStateIssuer
100244192MedicaidWI
20163900MedicaidWI

Other names 1

  • LindenGrove Waukesha Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230803000484 WI Part A Provider - Skilled Nursing Facility 0749641058 Practice locations: Waukesha, WI

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1780766451. Details of each certification follow.

Skilled nursing facility certification: CCN 525422

Legal name
LINDENGROVE COMMUNITIES LLC
Doing business as
LINDENGROVE WAUKESHA
Certification status
Active
Provider type (POS)
Nursing home – SNF (Medicare) only
Participating since
Feb 24, 1989
Last certification
Jun 11, 2024
Beds
61
Ownership / control type
Nonprofit Corporation
Multi-facility organization
ILLUMINUS
Organization structure
LLCNon-profit
Incorporated
Jan 16, 2023 in WI
Enrollment address
425 N University Dr
Waukesha, WI 53188-3174
Nursing home name
LINDENGROVE WAUKESHA

Other NPIs with the same Medicare PAC ID 3

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Care Compare: Nursing home

Medicare Care Compare
Listed as
Lindengrove WaukeshaCCN 525422 · All quality measures
Overall star rating
1 of 5
Health inspections
1 of 5
Staffing
3 of 5
Quality measures
1 of 5
Type
Medicare
Ownership
Non profit - Corporation
Certified
Feb 24, 1989
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
6156.7 residents per day on average
Penalties (3 years)
2Fines totaling $204,321

Processed by Care Compare on Aug 1, 2026.

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
52D0664473Lindengrove-Waukesha425 N University Drive, Waukesha, WI 53188Certificate of waiverAug 31, 2026

National Provider Directory

National Provider Directory
Tax ID family
Lindengrove Communities LLC9 organizations share this tax ID, including this one

Other organizations with this tax ID 8

Organizations that report the same tax identification number in the National Provider Directory.

Locations

13700 W National Ave
New Berlin, WI 53151
Phone (262) 797-7979

Ownership & related parties

All disclosed owners & managing parties 15

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Matthew R Mauthe Individual Corporate OfficerCeo Mar 20, 2023 100%
Operational/Managerial ControlCeo Mar 20, 2023
Adp of the SNF Mar 20, 2023
Todd Fischer Individual Corporate DirectorBoard Chair Mar 7, 2023
Managing Control - Governing BodyManager Mar 7, 2023
Illuminus Inc Organization, Watertown, WI Corporation, Management services company, Non-profit Operational/Managerial Control Mar 20, 2023 100%
Adp of the SNF Jul 14, 2025
Scott Dettman Individual Corporate DirectorSecretary/Treasurer Sep 1, 2020
Sarfraz Sidhu Individual Operational/Managerial Control Nov 16, 2020
Adp of the SNF Nov 16, 2020
The Hills at Cortland Ridge, Inc. Organization, Watertown, WI Corporation, Holding company, Non-profit, Owned by another organization or individual 5% Or Greater Direct Ownership Interest Feb 14, 2023 100%
Kevin Kohlhoff Individual Corporate DirectorDirector Sep 1, 2023
Robert Meidenbauer Individual Corporate DirectorVice Chair Mar 7, 2023
Katie Van Der Linden Individual Corporate DirectorDirector Mar 7, 2023
Adam Lembke Individual Operational/Managerial Control Mar 20, 2023
Adp of the SNF Apr 28, 2025
Marquardt Village Inc Organization, Watertown, WI Corporation, Non-profit 5% Or Greater Indirect Ownership Interest Mar 7, 2023 100%
Dennis Konkol Individual Corporate DirectorDirector Oct 1, 2024
Steven Heroux Individual Corporate DirectorDirector Aug 1, 2024
Lynne Wagner Individual Corporate DirectorDirector Oct 1, 2024
Julie Marks Individual Corporate OfficerManager Jun 5, 2025
Operational/Managerial Control Jun 5, 2025
Adp of the SNF Jun 5, 2025

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Facilities with the same owner 12

Facilities that share an organizational owner with 5% or greater ownership or operational control.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1161302400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1783641600000",
    "number": "1780766451",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1045 HILL ST",
            "city": "WATERTOWN",
            "state": "WI",
            "postal_code": "530983015",
            "telephone_number": "920-261-0400",
            "fax_number": "920-261-4840"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "425 N UNIVERSITY DR",
            "city": "WAUKESHA",
            "state": "WI",
            "postal_code": "531883174",
            "telephone_number": "262-524-6400",
            "fax_number": "262-524-9233"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LINDENGROVE COMMUNITIES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-20",
        "last_updated": "2026-07-10",
        "certification_date": "2026-07-10",
        "status": "A",
        "authorized_official_last_name": "MARKS",
        "authorized_official_first_name": "JULIE",
        "authorized_official_middle_name": "ANNE",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "920-261-0400"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "WI",
            "license": "2972",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100244192",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "20163900",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "LindenGrove Waukesha",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Waukesha, WI

Sources for this page

Verify at the official NPI Registry.